From good to bad fibroblasts: New promising targets to cure Chron's disease

Perianal fistulizing Crohn’s disease is a very disabling condition with poor quality of life. Patients with perianal fistulizing Crohn’s disease are also at risk of perianal fistula-related squamous cell carcinoma (SCC). Cancer arising at the site of a chronic perianal fistula is rare in patients with Crohn’s disease and there is a paucity of data regarding its incidence, diagnosis and management. A systematic review of the literature was undertaken using Medline, Embase, Pubmed, Cochrane and Web of Science. Several small series have described sporadic cases with perianal cancer in Crohn’s disease. The incidence rate of SCC related to perianal fistula was very low (<1%). Prognosis was poor. Colorectal disease, chronic perianal disease and HPV infection were possible risk factors. Fistula-related carcinoma in CD (Chron’s disease) can be very difficult to diagnose. Examination may be limited by pain, strictures and induration of the perianal tissues. HPV is an important risk factor with a particular carcinogenesis mechanism. MRI can help clinicians in diagnosis. Examination under anesthesia is highly recommended when findings, a change in symptoms, or simply long-standing disease in the perineum are present. Future studies are needed to understand the role of HPV vaccination in preventing fistula-related cancer.

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Actinomycosis of the caecum simulating carcinoma in a patient with a long-term intrauterine device

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0906285c ◽

2009 ◽

Vol 137 (5-6) ◽

pp. 285-287 ◽

Cited By ~ 2

Author(s):

Radoje Colovic ◽

Nikica Grubor ◽

Marjan Micev ◽

Stojan Latincic ◽

Slavko Matic ◽

...

Keyword(s):

Differential Diagnosis ◽

Intrauterine Device ◽

Right Hemicolectomy ◽

Bacteriological Examination ◽

Ascending Colon ◽

Vaginal Secretion ◽

Chron's Disease ◽

Irregular Form ◽

Localized Disease

Introduction. Actinomycosis of the caecum is a rare, but most frequently an abdominally localized disease. It often simulates inflammatory malignancy, rarely a periappendicular abscess or Chron's disease and is only exceptionally the cause of intestinal obstruction or bleeding. Case Outline. The authors present a 35-year-old woman with an intrauterine device which remained inserted for over three years, causing the development of pain, fever, vaginal secretion and bleeding that continued even after the device was removed. Ultrasonography showed a tumorous mass of irregular form located close to the uterus, which after a few months developed into a colliquation filled with pus requiring incision. Bacteriological examination failed to show actinomycosis. Due to the tumorous lesions involving the terminal ileum, appendix, caecum, ascending colon and omentum, a right hemicolectomy was performed. Based on histolopathological findings of the resected sample the diagnosis of actinomycosis was made. Therefore, after surgery the patient began treatment with antibiotics resulting in full recovery. Conclusion. Although rare, actinomycosis of the caecum should be taken into consideration in the differential diagnosis of tumorous lesions of the caecoascending part of the colon, particularly if the tumour is associated with inflammation.

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Measured and Predicted Basal Metabolic Rate in Inflammatory Bowel Disease Patients

Current Developments in Nutrition ◽

10.1093/cdn/nzaa049_017 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 624-624

Author(s):

Luiz Dos Anjos ◽

Tatiana Campos ◽

Juliana Dantas ◽

Fernanda Fernandes ◽

Vivian Wahrlich

Keyword(s):

Inflammatory Bowel Disease ◽

Metabolic Rate ◽

Basal Metabolic Rate ◽

Bowel Disease ◽

Anthropometric Measures ◽

Predictive Equations ◽

Women Subjects ◽

Funding Sources ◽

Chron's Disease ◽

Inflammatory Bowel

Abstract Objectives To measure basal metabolic rate (BMR) and to compare the values with estimated BMR from international and local predictive equations in inflammatory bowel disease (IBD) patients. Methods A total of 72 (38 women) subjects with Chron's disease (n = 45, 19 women) and ulcerative colitis (n = 27, 19 women) from an outpatient care unit in Rio de Janeiro, Brazil, agreed to participate in the study. Anthropometric measures were obtained using standard procedures. Percent body fat (PBF) was assessed by DXA. BMR was measured (BMRm) by indirect calorimetry (Vmax Encore 29) under standardized conditions and compared with BMR estimated by internationally-recommended (Schofield, 1985) and locally-developed (Anjos et al., 2014) predictive equations. Bias was calculated as estimated - measured BMR. Results The mean ± SD (range) age was 38.0 ± 11.3 (20.1 – 58.3) years with a mean BMI of 24.7 ± 4.5 (16.1 – 39.1) kg.m−2 and PBF of 32.2 ± 9.1 (9.7 – 53.4). BMRm was significantly lower in women (1169.3 ± 205.0) than men (1439.0 ± 197.5) kcal.day−1. The Schofield's equations significantly overestimated BMR for both women (bias of 204.0 ± 148.3 kcal.day−1 or 17.4%) and men (306.7 ± 171.0 kcal.day−1 or 21.3%). The locally-developed equation yielded nonsignificant estimates for both women (−5.8 ± 143.7 kcal.day−1 or −0.5%) and men (−19.9 ± 165.5 kcal.day−1 or −1.4%). Conclusions The findings of the present study indicate that internationally-recommended BMR predictive equations are not accurate to estimate BMR in IBD patients in a tropical setting. As observed in samples of healthy adults from the same city, the locally-developed BMR equations yield unbiased and accurate estimates for IBD patients. Funding Sources CNPq (310,461/2016–20) and FAPERJ (E-26/202.514/2018; E-26/203.068/2018; E-26/203.068/2017; E-26/202.520/2016; E-26/210.747/2016).

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Associated thyreoiditis, myasthenia gravis, thymectomy, Chron’s disease, and erythema nodosum: pathogenetic and clinical correlations, immune system involvement, and systemic infectious complications

Rheumatology International ◽

10.1007/s00296-008-0579-7 ◽

2008 ◽

Vol 28 (11) ◽

pp. 1173-1175 ◽

Cited By ~ 4

Author(s):

Roberto Manfredi ◽

Giovanni Fasulo ◽

Ciro Fulgaro ◽

Sergio Sabbatani

Keyword(s):

Immune System ◽

Myasthenia Gravis ◽

Erythema Nodosum ◽

Infectious Complications ◽

System Involvement ◽

Chron's Disease ◽

Clinical Correlations

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Pathophysiology of Crohn’s disease inflammation and recurrence

Biology Direct ◽

10.1186/s13062-020-00280-5 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

L. Petagna ◽

A. Antonelli ◽

C. Ganini ◽

V. Bellato ◽

M. Campanelli ◽

...

Keyword(s):

Extracellular Matrix ◽

Innate Immunity ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Surgical Approaches ◽

Disease Evolution ◽

Limited Success ◽

Tnf Α ◽

Chron's Disease

Abstract Chron’s Disease is a chronic inflammatory intestinal disease, first described at the beginning of the last century. The disease is characterized by the alternation of periods of flares and remissions influenced by a complex pathogenesis in which inflammation plays a key role. Crohn’s disease evolution is mediated by a complex alteration of the inflammatory response which is characterized by alterations of the innate immunity of the intestinal mucosa barrier together with a remodeling of the extracellular matrix through the expression of metalloproteins and increased adhesion molecules expression, such as MAcCAM-1. This reshaped microenvironment enhances leucocytes migration in the sites of inflammation, promoting a TH1 response, through the production of cytokines such as IL-12 and TNF-α. IL-12 itself and IL-23 have been targeted for the medical treatment of CD. Giving the limited success of medical therapies, the treatment of the disease is invariably surgical. This review will highlight the role of inflammation in CD and describe the surgical approaches for the prevention of the almost inevitable recurrence.

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